A new independence

Winter 2011

Soon after I started as a Macmillan occupational therapist (OT), I received a call from the haematology ward sister. She asked me to help a young woman with T-cell lymphoma who was undergoing chemotherapy in preparation for a stem cell transplant. The sister felt she would benefit from some anxiety management strategies.

Rachel[1], 31, had recently returned from Australia after her diagnosis. She told me she was feeling anxious about her treatment and that she was upset at having to change her living situation and lose her independence and autonomy.

OTs help people adjust to changing circumstances, their medical conditions and their ability to carry out everyday activities. When a person is anxious or stressed, an OT will try to use that person’s usual coping strategies to reduce the distressing feelings. For people whose coping strategies are ineffective or impractical, we offer the opportunity to learn new strategies.

Rachel had always enjoyed exercise, using it to ‘let off steam’ and manage her stress. But she was so weakened by the chemotherapy that she was walking with a stick and spent much of her time resting. Helping Rachel to use exercise to manage her anxiety was going to be a challenge.

I also knew that she needed to be very careful of infection risk, so asking her to join a local gym wasn’t going to be the answer.

We started small - I borrowed a corner of the physiotherapy department gym and Rachel started using the stationary bike for just five minutes at a time. As the weather improved, we ventured outside to the ‘green gym.’ We even tried t’ai chi for balance and some boxing for upper body strength.

Rachel recognised that for her to have the best chance of tolerating the transplant, she would need to be as fit as possible.

She underwent the transplant 12 months ago, and despite being upset at losing some condition following the procedure, she knew that it would have been far worse had she not been as strong as she was prior to it. Following the transplant, I helped Rachel to prepare for her long-term goal of running the Swansea Bay 10km in September, which we successfully ran together.

Throughout her recovery, Rachel has been taking small steps to improve her life and increase her independence.

When asked about the impact that occupational therapy had on her recovery, she said, ‘My recovery would have been even more challenging without Wendy being there. She was a sounding board for questions I didn’t know who else could answer.’

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Macmillan Cancer Support, registered charity in England and Wales (261017), Scotland (SC039907) and the Isle of Man (604). A company limited by guarantee, registered in England and Wales company number 2400969. Isle of Man company number 4694F. Registered office: 89 Albert Embankment, London SE1 7UQ.